u/Dead_Mullets

I’m hoping to get some input from other practice owners, supervisors, billers, or clinicians who have experience with family/couples billing and documentation.

I’m looking more closely at the use of 90847 and want to make sure I’m educating associates appropriately around documentation, medical necessity, and billing risk. Specifically, I’m wondering about:

1. What documentation standards do you use when billing 90847?
2. How do you clearly show that the session is clinically necessary and not simply “relationship coaching” or a general support session?
3. What are the common mistakes you’ve seen that could lead to clawbacks, payer scrutiny, or audits?
4. Have you seen insurers question 90847 claims when the focus is couples work, family conflict, parenting, or relational distress?
5. How do you train associates to document who the identified client is, how the family/couple interaction relates to the client’s diagnosis, and what interventions were used?
6. Are there any red flags you recommend avoiding in notes, superbills, or treatment plans?

I’m not looking for legal advice, and I understand payer policies vary. I’m more interested in best practices, risk management considerations, and how others educate clinicians to use 90847 appropriately and ethically.

We have a group of 13 people going to Kona, it's through airbnb but it's a company that has a lot of houses on airbnb. Our trip is this Friday and they are wanting to swap us to a different house. The one we paid for was around 5800, and we took a screenshot of the other house they are sending us to last night and it's listed for 2800. They blocked out the first day of our trip on airbnb probably so we couldnt see the price, but we already saw it and have evidence.

We messaged them last night and they were responsive at first, but after asking about price matching for the new house they havent responded.

Should we involve airbnb?